Eosinophilic gastritis

Eosinophilic gastritis
Diagnosis in short
Stomach with eosinophilia. H&E stain.
LM	abundant eosinophils (>=127 eosinophils/mm2)
LM DDx	chronic gastritis, Helicobacter gastritis, Crohn's disease - see inflammatory bowel disease and the stomach, eosinophilic myeloproliferative neoplasm, eosinophilic gastroenteritis
Site	stomach
Symptoms	+/-abdominal pain
Prevalence	very rare
Prognosis	benign?
Clin. DDx	other causes of gastritis

Eosinophilic gastritis, abbreviated EG, is an uncommon inflammatory process of stomach characterized by abundant eosinophils.

General

• Rare.

Clinical:

• Abdominal pain.
• May mimic a gastric tumour.

Gross

• +/-Snakeskin appearance.

DDx:

• Portal hypertensive gastropathy.

Microscopic

Features:

• Abundant eosinophils -- >=127 eosinophils/mm².
  • 30 eosinophils/HPF, if the field diameter of 1 HPF is 0.55 mm.

Notes:

• Normal range:
  • <38 eosinophils/mm².
    • Typically ~16 eosinophils/mm².
• Mild eosinophilia is seen in:
  • Crohn's disease ~ 31 eosinophils/mm² (range: 0-203 eosinophils/mm²).
  • Helicobacter gastritis ~ 25 eosinophils/mm² (range: 0-219 eosinophils/mm²).

DDx:

• Chronic gastritis.
• Helicobacter gastritis.
• Crohn's disease - see inflammatory bowel disease and the stomach.
• Eosinophilic myeloproliferative neoplasm.
• Eosinophilic gastroenteritis.
• Inflammatory fibroid polyp - spindle cells.

Sign out

Focal eosinophilia

STOMACH, BIOPSY:
- BODY AND ANTRAL-TYPE GASTRIC MUCOSA WITH MODERATE CHRONIC ACTIVE INFLAMMATION AND
  FOCAL EOSINOPHILIA.
- NEGATIVE FOR HELICOBACTOR-LIKE ORGANISMS.
- NEGATIVE FOR INTESTINAL METAPLASIA.
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.

COMMENT:
One of four tissue fragments has eosinophilia, with 45 eosinophils/1 HPF (where 1 HPF 
is 0.2376 mm*mm).

See also

• Stomach.
• Eosinophil.
• Eosinophilic colitis.
• Eosinophilic esophagitis.